Wednesday, February 25, 1998

Businesses urged to oppose health care bill

By RICHARD HORN and DOUG WILLIAMSON / Abilene Reporter-News

Large national companies may withdraw health care benefits from their employees if proposed legislation passes through Congress.

The bill could open businesses up to liability claims over health care services provided through insurance and managed care plans, said Keith Kouba, a government affairs representative with the Texas Association of Business and Chambers of Commerce.

Kouba spoke to two dozen local business representatives Tuesday as a part of a statewide awareness campaign.

He urged businesses to oppose HR 1415, a bill authored by U.S. Rep. Charles Norwood of Georgia and co-sponsored by 220 other congressmen, including Charles Stenholm, D-Abilene.

The bill states "employers are exempt (from litigation), except when they use their discretion," Kouba said. "Employers are not protected. The direct liability is the big problem."

Kouba explained that "discretion" has been interpreted to be any act, such as choosing which benefit plans a company makes available to its employees.

"These are problems for businesses, especially multi-state employers. The large companies will drop (employee) insurance (benefits) if it passes," he said.

Stenholm is aware of business concerns about the Norwood Health Care Bill, and insisted they're being addressed. But he defends being a co-sponsor of the Norwood bill and won't back off.

"I'm very concerned about the growing division between the doctor and his or her patient," Stenholm said. "The thing that caught my interest in the Norwood bill is trying to get back to a patient-doctor relationship instead of a patient-HMO relationship, or patient-entity relationship."

Stenholm said Monday, and Norwood has insisted in public statements, that sponsors are going to make sure companies that do not make health decisions are not held liable.

It was never intended to penalize business for an HMO's decision, Stenholm said, but he stressed health consumers and health professionals need better protection.

As it is now under interpretation of existing law, he said, health maintenance organizations cannot be held liable nationally even though HMOs are, in the view many doctors, making health care decisions.

"That has to be corrected, because you must have accountability for your actions, and it can't just be the doctor or the nurse," he said. "If a third party has interjected itself between the patient and doctor, they too have to be liable if they are making the decision as to who gets health care and who does not."

Stenholm is catching heat over his stance on the issue.

A national business group is running ads accusing him of backing "just another Bill Clinton-Ted Kennedy health care scheme."

He said the group Ñ Small Business Survival Committee Ñ is wasting its money.

He said he phoned the business organization after learning of the ad and told its leaders, "Next time, I could save you a little money if you just call me and say 'Here are my concerns,' because we've already worked out most of those concerns.

"They didn't have to run and spend that kind of money Ñ calling it a Kennedy-Clinton bill when it's really a Republican bill," he added. "That's not right."

Kennedy, in fact, is expected to unveil a Democratic alternative this week, the Wall Street Journal reported Monday. And the "Blue Dog" coalition of conservative Democrats may present its own version if necessary, Stenholm said.

The radio ad began running late last week in Abilene and the 17th District, attacking Stenholm's co-sponsorship of the HMO regulation bill.

"It's supposed to increase access to health care, but it's just something else to make health insurance more for small business and families without coverage where they work," the ad announcer says.

"It's similar to a bill in Ted Kennedy's Massachusetts that raised health insurance costs to $16,000 a year for a family with two children," the ads says. "Do you want Congressman Stenholm to do that to us here in Texas?"

The bill would allow patients to appeal a denial of care to an outside panel, sue HMOs if they are hurt by a decision, and choose their own doctors Ñ though they would have to pay extra if the doctor was outside the network.

His bill also would guarantee payments for emergency room visits and access to specialists.

Karen Kerrigan, president of the Small Business Survival Committee, said Norwood's bill is "as close to 'Clinton Care' as you can get."

She agrees the ads target conservatives, including Stenholm and Norwood, who are known as friendly to small-business issues. But she said even Kennedy's Democratic alternative may be better than Norwood's version.

"The Norwood bill is a pretty massive federal regulatory approach," she said. "It probably can be dealt with at state level rather than a one-size fits all approach."